Dealer Rebate Form | Icon Vehicle Dynamics -

Thank you for purchasing through the ICON distribution network!
Please submit the information from your purchase below along with a completed W9 form.
This form will allow you to submit one invoice at a time. ICON will validate the purchase through the distributor listed in the submission.
Please allow up to 90 days from the time of submission to process your rebate. Rebate to be made payable to the business entity listed on the submitted invoice only.

Dealer Rebate Form (2023)

Name*
First Last
Your Shop’s Name*
Your Title*
Email*
Phone*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Warehouse Distributor your purchased the product from:*
Your Invoice Number:*
ICON Product Total on Invoice in Dollars:*
Upload the invoice you received from the Warehouse Distributor*
Max. file size: 10 MB.
Upload a copy of your completed W9 Form*
Max. file size: 10 MB.
CAPTCHA